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  5. SOUTHERN CONNECTICUT DERMATOLOGY, P.C.

SOUTHERN CONNECTICUT DERMATOLOGY, P.C.

Company Details

Entity Name: SOUTHERN CONNECTICUT DERMATOLOGY, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 05 Sep 1995
Business ALEI: 0521469
Annual report due: 05 Sep 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 1275 SUMMER STREET SUITE 101, STAMFORD, CT, 06905, United States
Mailing address: 1275 SUMMER STREET SUITE 101, STAMFORD, CT, United States, 06905
ZIP code: 06905
County: Fairfield
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: rdemd@aol.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2023 061434391 2024-07-16 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, SUITE 101, STAMFORD, CT, 069055315

Signature of
Role Plan administrator
Date 2024-07-16
Name of individual signing CHAD CARROLL
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2023 061434391 2024-07-03 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 15
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, SUITE 101, STAMFORD, CT, 069055315

Signature of
Role Plan administrator
Date 2024-07-03
Name of individual signing ROBIN EVANS, M.D.
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2022 061434391 2023-10-13 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 06905
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2021 061434391 2022-10-05 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2022-10-05
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-05
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2020 061434391 2021-10-15 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-15
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2019 061434391 2020-03-22 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2020-03-22
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-03-22
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2018 061434391 2019-09-15 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2019-09-15
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-15
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2017 061434391 2018-10-11 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-11
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2016 061434391 2017-07-26 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-26
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN CONNECTICUT DERMATOLOGY P.C. 401(K) PROFIT SHARING PLAN 2016 061434391 2017-06-09 SOUTHERN CONNECTICUT DERMATOLOGY, P.C. 10
Three-digit plan number (PN) 002
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2033235660
Plan sponsor’s address 1275 SUMMER STREET, STAMFORD, CT, 069055313

Signature of
Role Plan administrator
Date 2017-06-09
Name of individual signing ROBIN EVANS, M.D., TRUSTEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-09
Name of individual signing ROBIN EVANS, M.D., PRESIDENT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
ROBIN EVANS M.D. Agent 1275 SUMMER STREET, STAMFORD, CT, 06905, United States 425 OCEAN DRIVE WEST, STAMFORD, CT, 06902, United States +1 203-912-5869 rdemd@aol.com 425 OCEAN DRIVE WEST, STAMFORD, CT, 06902, United States

Officer

Name Role Business address Phone E-Mail Residence address
ROBIN EVANS M.D. Officer 1275 SUMMER STREET, SUITE 101, STAMFORD, CT, 06905, United States +1 203-912-5869 rdemd@aol.com 425 OCEAN DRIVE WEST, STAMFORD, CT, 06902, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012360828 2024-08-22 No data Annual Report Annual Report No data
BF-0011257841 2023-08-08 No data Annual Report Annual Report No data
BF-0010236037 2022-08-08 No data Annual Report Annual Report 2022
BF-0009812401 2021-10-11 No data Annual Report Annual Report No data
0007215734 2021-03-10 No data Annual Report Annual Report 2020
0006742461 2020-02-05 No data Annual Report Annual Report 2016
0006742464 2020-02-05 No data Annual Report Annual Report 2017
0006742471 2020-02-05 No data Annual Report Annual Report 2019
0006742468 2020-02-05 No data Annual Report Annual Report 2018
0006742455 2020-02-05 No data Annual Report Annual Report 2015

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Connecticut's Official State Website

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